Accepting New Patients!

Crestview Office: (850) 689-0900

Niceville Office: (850) 729-3575

Insurance 101

The providers of ABC Pediatrics of Okaloosa strongly agree with the American Academy of Pediatrics recommendations tha your child receive regularly scheduled checkups and routine follow-up of chronic conditions such as asthma or ADHD. These visits may include developmental forms, routine labs, and testing of hearing and vision.

Due to all the recent changes in the health insurance industry, our billing department receives many calls from parents with questions regarding their bills and charges uncurred during a “check-up” or “sick visit”. We have developed this informational sheet to educate our families on what ot expect at the time of your visit. We ask that your read it, and if you have any questions,, please call the billing office at 850-689-0900.

If you have changes in your insurance it is important to update this information with us as soon as possible to avoid denials from your insurance company due to timely filing limitations.

Please make sure you add your newborn to your insurance plan within 30 days of birth.

Newborns – Your first visit is typically a well visit. We follow AAP guidelines and would like to see your newborn 1-3 days after hopital discharge. Your physician will check that your baby is starting to gain weight, how your baby is feeding, and look for signs of jaundice. If any of these conditions are addressed at the well bist, a sick visit may also be billed. If your physician requests that you retern to the clinic to recheck your baby, this will be charged as a sick visit.

In addition, well visits are typically performed at, 2 months, 4 months, 6 months, 9 months, 12 months, 15 months,18 months. Any other visits are charged as “sick visits” even if the child is not considered sick. An example of this would be if your child is teething and you would like the physician to examine him or her.

Well Checks – During check-ups for all children:

Measure height, weight and head circumference (depending on age) and plot them on a growth chart.

A body mass index (BMI) is calculated for all children 3 years and older

Check body parts and systems

Discuss age related expectations and guidance

Discuss age appropriate nutrition

Discuss schooling(if age appropriate)

Fill out forms for daycare/sports

Other concerns that are more complicated and involve more time or expertise such as chronic (prolonged duration) headaches, stomach pains, psychological/school problems, ADHD rechecks, asthma rechecks, or other medical issues usually require a separate code and charge in addition to the check-up. Addressing these concerns during your well check may result in your being charged for a sick visit in addition to your well visit. Your insurance company will apply a copayment/deductible for the sick visit. You may be advised to schedule a separate visit to address any chronic issues.

Summary

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